Successful & Healthy Aging

Patricia Roy, RPN RN BSN MNGNC(C)

FH Clinical Nurse Specialist Older Adult Program

Outline

� Aging

� Successful Aging

� Healthy Aging� Healthy Aging

� Definitions and comparing

� Prevention & Health Promotion

� Recommendation for Successful aging

� Evaluation

Normal aging

� Combined effect of the aging process, disease, and adverse environmental and lifestyle factors (Lakatta, 1995)

Rule of thirds (Sloane, 1992): � Rule of thirds (Sloane, 1992): � 1/3 age-related changes

� 1/3 due to inactivity or disuse

� 1/3 are cause by aging itself

Source: Lakatta & Sloane in Ebersole & Hess (2001). Geriatric Nursing & Healthy Aging.

Discussion questions

� What do you think accounts for the major differences in how people experience aging?experience aging?

� What are some of the major changes in society’s attitudes about aging?

� What lessons have you learned from older adults in your life?

What is “successful aging”?

� Freedom from chronic disease and the ability to continue to function effectively, both physically and mentally in old age (Britton et al, 2008) – medical modelal, 2008) – medical model

� Includes maintenance of physical & mental function & continued involvement in social activities and relationships (Kennedy, 2000) –more nursing & other disciplines model

Maslow’s Hierarchy of Needs

Self actualization

Self-esteemSelf-esteem

Belonging

Safety & Security

Biologic integrity – basic needs

Questions

� What type of questions would be helpful to identify/assess a patients hierarchy of need?hierarchy of need?

� Give examples, for each level…

What is…Health, Wellness, & Wellbeing

� Health – emphasizes strengths, resilience, resources, and capabilities rather than focusing on pathology� WHO def. A state of complete physical, mental, and social wellbeing, not

merely the absence of disease and infirmity

� Wellness – involves one’s whole being: physical, emotional, mental, � Wellness – involves one’s whole being: physical, emotional, mental, social, cultural and spiritual processes� Based on the belief that every person has an optimal level of function

regardless of their situation (living with chronic illness, dying)� Attainable with supports & encouragement allow the individual to make

meaning out of the present situation

� Wellbeing – perception of how the individual feels & what they are able to accomplish in the face of diminishing physical & mental faculties (resilience)

*Nursing mission: assist the individual to achieve the highest level of adaptation to whatever situation exists.

Healthy Aging definition

� Process of decreasing morbidity (illness or disease) and increasing the age of mortality (death) rates – medical model

Process of slowing down, physically & � Process of slowing down, physically & cognitively, while resiliently adapting and compensating in order to optimally function & participate in all areas of one`s life (physical, cognitive, social, & spiritual) (Hansen-Kyle, 2005) – Nursing & other disciplines

Attributes/Characteristics of Healthy Aging

� Continuous process of change and adaptation

� Self defined & individualistic

� Slowing down of body processes

� Acceptance and movement towards death� Acceptance and movement towards death

� Desire to continue to actively participate in life processes

� Ability to function physically, cognitively, and socially

� Continual modification, self-assessment, & redefinition of self & abilities

Source: Hansen-Kyle, 2005

Activity: What factors influence Healthy Aging?

Physiological Cognitive/Mental Social/Support

Concept Analysis: Healthy Aging

Antecedents – what is needed for healthy aging

� Adaptation – ability to redefine oneself in terms of independence and autonomyindependence and autonomy

� Compensation – ability to change one’s lifestyle to accommodate the physical changes that have occurred

� Resilience – ability to bounce back, to change, and to adapt

Adaptation + Compensation leads to Resilience

Source: Hansen & Kyle, 2005

Consequences of Healthy Aging

� Successful aging – ability to establish and maintain stated goals or lifestyle & involvement in prescribed roles

� Independence – ability to live on one’s own � Independence – ability to live on one’s own terms and actively participate in one’s own care

� Autonomy – ability & the desire to make decisions regarding one’s care

Source: Hansen-Kyle, 2005

Traits of a Healthy Person

� Attuned to mind-body signals, e.g. pain, pleasure, fatigue, anger, sadness

� Can confide in another person� Can confide in another person

� Exhibit control over own health and quality of life

� Strong sense of commitment to work, creative activities, & relationships

� See stress as a challenge rather than a threat

Traits of a Healthy Person (cont)

� Demonstrates approp. assertiveness concerning needs and feelings

� Forms relationships based on unconditional love rather than powerlove rather than power

� Is altruistically committed to helping others� Is willing to explore many different facets of own personality, which will provide strength to fall back on if one fails

Source: Dreher (1995). The immune power personality: 7 traits you can develop to stay healthy. In Ebersole & Hess (2001)

Dimensions of Wellness

� Self-responsibility (self efficacy)

� Nutrition awareness

� Physical fitness� Physical fitness

� Stress management

� Environmental sensitivity (includes the world, neighbourhood, home and room)

Recommendations for Successful Aging

� Proactive engagement in certain health behaviours in mid-life that will increase the likelihood of reaching & maintaining the goal of successful aging in later life:of successful aging in later life:� Prevent disease-related problems

� Prevent cognitive impairment

� Prevent later-life depression & relapses

Source: Pascucci, 2008. A message for boomers.

How does science/research measure health parameters?

� Nutritional status & risk – bodyweight, body fat, BMI, plasma lipids, albumin, glucose, bone mineral density, BP

� Physical activity – strength, flexibility� Physical activity – strength, flexibility

� Function/self care – ADLs and IADLs

� Mental/cognitive function– depression scale, MMSE, suicide risk, CAGE

� Social support systems – caregiver burden, social networks

� Quality of life – life satisfaction

What can we do?

� Prevention – screening & early detection

� Health promotion – education & activity to prevent & limit the effects of disease

� Treating proactively & early with improved discharge � Treating proactively & early with improved discharge teaching & reconciliation back home

� Assist with growth & development – Maslow`s hierarchy of needs

� Lobby government to change policy, holistic care which includes social programs, affordable housing, transportation, safe neighbourhoods, nutrition programs

� Get professional organizations involved – RN Network of BC, CGNA, GNGBC, help guide & define policy priorities, CRNBC not able to advocate like before

3 Strategies to cope with the challenges of aging

1. Reduce # of activities they participate in by focusing on activities they can do (e.g. walk instead of job, plant in a flower box rather than a big garden)than a big garden)

2. Practice critical skills to remain adept (e.g. take courses, Xwords puzzles)

3. Compensate/adapt to overcome obstacles (e.g. use aides, make lists, drive during day light hours)

Source: CHR Fact Sheet (2002). Successful Aging

What can be done?

� Goal: Enhance quality of life

� Listen & address client issues/needs

� Assess and enhance determinants of � Assess and enhance determinants of health: mental, physical, socioeconomic, cultural, spiritual and environmental

� Gradually introduce prevention and health promotion activities: physical activity, nutrition, healthy eating

Summary: Healthy vs Successful aging:

� Healthy aging can only occur if the antecedents to healthy aging are in place: adaptation, compensation, & place: adaptation, compensation, & resilience

� Successful aging is goal driven…it is a consequence of healthy aging, like autonomy and independence

Source: Hansen-Kyle (2005).

Questions??

�Complete Evaluation & hand-inhand-in

�Thank you

Reference List

� Britton, Shipley, Singh-Manoux & Marmot (2008). Successful Aging: The contribution of Early-Life and Midlife Risk Factors, JAGS, 56, 1098-1105.

� Calgary Health Region (2002). Fact Sheet: Successful Aging.� Dreher (1995). The immune power personality: 7 traits you can

develop to stay healthy. In Ebersole & Hess (2001)develop to stay healthy. In Ebersole & Hess (2001)� Drewnowski, Monsen, Birkett, Gunther, Vendeland, Su, & Marshall.

(2003). Health screening and health promotion programs for the elderly. Dis Manage Health Outcomes, 11(5), 299-309

� Ebersole & Hess (2001). Geriatric Nursing & Healthy Aging. St. Louis, MS: Mosby

� Hansen-Kyle (2005). A concept analysis of healthy aging, Nursing Forum, 40(2), 45-57.

� Kennedy, G. (2000). Geriatric mental health care: a treatment guide for health professionals. New York: Guildford Press.

� Pascucci, M. (2008). A message for boomers, Take good care of yourself. Journal of Gerontological Nursing, 34(3), 3.